DOUGLAS EDWARD KELLEY OD Optometrist License verification

Business Entity

NOT RENEWED

License Type

Optometrist

Description

OPTOMETRIST CONTROLLED SUBSTANCE

License Number

34*****45

License Status

NOT RENEWED

Business

First Name

DOUGLAS

Middle

EDWARD

Last Name

KELLEY

Suffix

Business Name

DOUGLAS EDWARD KELLEY OD

Original Issue Date

06/09/2008

Effective Date

06/09/2008

Expiration Date

03/31/2010

City

FREEPORT

State

Zip

61032

County

STEPHENSON

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

III IV V

Ever Disciplined

LastModifiedDate

05/04/2010